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End-of-life care

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https://www.readbyqxmd.com/read/28453799/early-to-mid-term-results-after-total-cavopulmonary-connection-performed-in-the-second-decade-of-life
#1
Alexandre Metras, Virginie Fouilloux, Mohammed Al-Yamani, Xavier Roques, Loic Macé, Jean-Benoît Thambo, Dominique Metras, Bernard Kreitmann, François Roubertie
OBJECTIVES: Total cavopulmonary connection (TCPC) performed in the second decade of life has rarely been studied. Thus, we investigated (bicentric study) early and late morbidity and mortality following completion of TCPC in these patients. METHODS: From January 1999 to June 2014, 63 patients (14.5 ± 2.9 years) underwent TCPC (extracardiac conduit). Palliation before completion was an isolated bidirectional cavopulmonary shunt (BCPS) in 3 patients or BCPS associated with additional pulmonary blood flow (APBF) that was either antegrade (Group 1) in 38 (63%) or retrograde (Group 2) in 22 (37%)...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28448328/hospice-or-community-network-choices-in-end-of-life-care-in-jamaica
#2
Roger Lee Mendoza
AIM: National and international healthcare agencies and organizations typically attribute slow or haphazard growth in hospice and palliative care in developing countries to various resource constraints. This study provides evidence of the substantial and widening gap between policy advocacy and individual decision-making concerning end-of-life care. It does so by establishing the incentives and risks that underlie choices of patients and providers against the relative scarcity of hospices in these countries...
April 26, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28446088/end-of-life-care
#3
(no author information available yet)
Skills for Health, Health Education England and Skills for Care have launched a new end of life education and training framework to provide tailored, high-quality care and support to patients with advanced incurable illness and their families.
April 27, 2017: Nursing Management (Harrow)
https://www.readbyqxmd.com/read/28445277/cancer-studies-based-on-secondary-data-analysis-of-the-taiwan-s-national-health-insurance-research-database-a-computational-text-analysis-and-visualization-study
#4
Jui-Kun Chiang, Chih-Wen Lin, Chun-Lung Wang, Malcolm Koo, Yee-Hsin Kao
There has been a surge in the academic publication output based on secondary analyses of the data from the Taiwan's National Health Insurance claim records. It has become a challenge to comprehend such a rapid expansion of the literature. Therefore, this study aimed to explore the conceptual content of National Health Insurance Research Database-based cancer research, using the abstract of articles extracted from PubMed between 2002 and 2015. Search terms including "National Health Insurance Research Database (NHIRD) AND Taiwan," "Taiwan AND population-based," and "Taiwan AND nationwide" were used to search in PubMed with the publication date limited to between 1997 and 2015...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28445100/remap-a-framework-for-goals-of-care-conversations
#5
Julie W Childers, Anthony L Back, James A Tulsky, Robert M Arnold
Conversations regarding goals of care with patients who have advanced cancer still occur too late, and oncologists say they lack the training to have these conversations effectively. Experts recommend a number of strategies when having these discussions, including discussing prognosis, responding to patient emotion, exploring values, and often making a recommendation for medical treatments that fit those values. To help learners, from residents to attending oncologists, learn these complex conversational skills, we have developed a framework with a mnemonic, REMAP: Reframe, Expect emotion, Map out patient goals, Align with goals, and Propose a plan...
April 26, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28444845/preoperative-sepsis-is-an-independent-risk-factor-for-major-complications-after-lower-extremity-amputation-in-patients-with-diabetic-end-stage-renal-disease
#6
Young Hwan Park, Jong Hyub Song, Gi Won Choi, Hak Jun Kim
AIM: Patients with diabetic end-stage renal disease (ESRD) are at increased risk of lower extremity amputation (LEA) and postoperative complications compared to those without diabetic ESRD. This study sought to determine the factors that influence complications following LEA in patients with diabetic ESRD. METHODS: A total of 41 patients with diabetic ESRD (total of 46 amputations) who underwent LEA were enrolled in this study. The electronic medical records were retrospectively reviewed to identify the predictors of postoperative complications...
April 26, 2017: Nephrology
https://www.readbyqxmd.com/read/28444724/the-morality-of-good-end-of-life-care-in-critical-care
#7
EDITORIAL
Natalie Pattison
No abstract text is available yet for this article.
May 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28444607/the-provision-of-spiritual-care-in-hospices-a-study-in-four-hospices-in-north-rhine-westphalia
#8
Andreas Walker, Christof Breitsameter
This article considers the role and the practices of spiritual care in hospices. While spiritual care was firmly established as one of the four pillars of practical hospice care alongside medical, psychological and social care by Cicely Saunders, the importance and functions of spiritual care in daily practice remain arguable. When speaking about spirituality, what are we actually speaking about? What form do the spiritual relations take between full-time staff and volunteers on the one hand, and the patients and their family members on the other? These were central questions of a qualitative study that we carried out in four hospices in North Rhine-Westphalia, Germany, to explore how spiritual care is provided in hospices and what significance spirituality has in hospices...
April 25, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28444072/chronic-obstructive-pulmonary-disease-exacerbation-in-the-intensive-care-unit-clinical-functional-and-quality-of-life-at-discharge-and-3-months-of-follow-up
#9
Renata Cristina Teixeira Pinto Viana, Mariangela Pimentel Pincelli, Emílio Pizzichini, André Pacheco Silva, Joice Manes, Tatiana Dias Marconi, Leila John Marques Steidle
Objective: The purpose of this study was to evaluate the clinical/functional aspects and quality of life of chronic obstructive pulmonary disease patients who were discharged after an intensive care unit admission for acute respiratory failure. Methods: This prospective study included chronic obstructive pulmonary disease patients who were admitted to two intensive care units between December of 2010 and August of 2011 and evaluated over three visits after discharge...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443343/impact-on-diabetes-self-management-and-glycemic-control-of-a-new-color-based-smbg-meter
#10
Oliver Schnell, Gerd Klausmann, Bettina Gutschek, Rosa Maria Garcia-Verdugo, Michael Hummel
BACKGROUND: Self-monitoring of blood glucose (SMBG) is a key pillar of personal diabetes management. The objective of this observational study was to analyze diabetes self-management (DSM) and glycemic outcomes before and during system implementation in real-life settings of a blood glucose meter system with a color-coded display of glucose levels, which helps identify out-of-range levels. METHODS: A total of 193 insulin-treated diabetes patients (11% T1DM; 55% male, age 60 ± 4 years, mean diabetes duration 14 ± 9 years, HbA1c 8...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28441339/still-searching-a-meta-synthesis-of-a-good-death-from-the-bereaved-family-member-perspective
#11
REVIEW
Kelly E Tenzek, Rachel Depner
The concept of a good death continues to receive attention in end-of-life (EOL) scholarship. We sought to continue this line of inquiry related to a good death by conducting a meta-synthesis of published qualitative research studies that examined a good death from the bereaved family member's perspective. Results of the meta-synthesis included 14 articles with 368 participants. Based on analysis, we present a conceptual model called The Opportunity Model for Presence during the EOL Process. The model is framed in socio-cultural factors, and major themes include EOL process engagement with categories of healthcare participants, communication and practical issues...
April 25, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28441157/new-role-of-mechanical-assist-device-as-bridge-to-transplant-usa-perspective
#12
Ambreen Mohamed, Natasha Mehta, Howard J Eisen
PURPOSE OF REVIEW: Cardiac transplant remains the gold standard of care for patients with end-stage heart failure. Unfortunately, due to the limited availability of donor hearts in the United States, not all eligible candidates are able to be transplanted. Since the introduction of mechanical assist devices for the treatment of advanced heart failure, patients gain a significant survival benefit while awaiting transplant. With rapidly evolving technology, it is important to appreciate the advances in the current use of mechanical assist devices...
April 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28440523/-outcome-of-watch-and-wait-strategy-or-organ-preservation-for-rectal-cancer-following-neoadjuvant-chemoradiotherapy-report-of-35-cases-from-a-single-cancer-center
#13
Aiwen Wu, Lin Wang, Changzheng Du, Yifan Peng, Yunfeng Yao, Jun Zhao, Tiancheng Zhan, Yong Cai, Yongheng Li, Yingshi Sun, Jiafu Ji
OBJECTIVE: To investigate the safety and efficacy of organ preservation surgery or "watch and wait" strategy for rectal cancer patients who are evaluated as clinical complete response(cCR) or near-cCR following neoadjuvant chemoradiotherapy (nCRT). METHOD: From March 2011 to June 2016, 35 patients with mid-low rectal cancers who were diagnosed as cCR or near-cCR following nCRT underwent organ preservation surgery with local excision or surveillance following "watch and wait" strategy in the Peking University Cancer Hospital...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28440125/palliative-care-education-for-medical-students-differences-in-course-evolution-organisation-evaluation-and-funding-a-survey-of-all-uk-medical-schools
#14
Steven Walker, Jane Gibbins, Paul Paes, Astrid Adams, Madawa Chandratilake, Faye Gishen, Philip Lodge, Bee Wee, Stephen Barclay
BACKGROUND: A proportion of newly qualified doctors report feeling unprepared to manage patients with palliative care and end-of-life needs. This may be related to barriers within their institution during undergraduate training. Information is limited regarding the current organisation of palliative care teaching across UK medical schools. AIMS: To investigate the evolution and structure of palliative care teaching at UK medical schools. DESIGN: Anonymised, web-based questionnaire...
June 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28437385/before-or-after-transplantation-a-review-of-the-cost-effectiveness-of-treating-waitlisted-patients-with-hepatitis-c
#15
Elliot B Tapper, Nezam H Afdhal, Michael P Curry
All patients with chronic hepatitis C virus (HCV) infections can and should be treated. Though highly effective direct-acting antiviral therapies are costly, the price of a cure is a 1-time investment that is outweighed by future benefits. For clinicians caring for patients requiring liver transplant, the key question relates to the timing of treatment: before or after liver transplantation? On 1 hand, treating HCV often improves our patients' model for end-stage liver disease (MELD) score, decreasing costs, and potentially improving longevity by reducing our patients' risk of death and transplantation...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#16
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437367/-effective-requesting-a-scoping-review-of-the-literature-on-asking-families-to-consent-to-organ-and-tissue-donation
#17
Jennifer A Chandler, Matthew Connors, Giles Holland, Sam D Shemie
BACKGROUND: Families are often asked to consent to the donation of their deceased relative's organs or tissues. These end-of-life conversations are important because they affect consent rates as well as the psychological impact of the decision for families. This scoping review of the literature on requesting family consent was prepared to support of the development of leading practice recommendations for end-of-life conversations with families of potential donors. A scoping review maps research activity in a field across a range of commentary and empirical study designs but does not attempt meta-synthesis of empirical data or quality assessment...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437210/factors-associated-with-length-of-stay-at-home-in-the-final-month-of-life-among-advanced-cancer-patients-a-retrospective-chart-review
#18
Masatomo Otsuka
BACKGROUND: Living at home is an important factor for maintaining high quality of life among patients. Many studies have discussed parameters associated with place of death, but no studies have yet clarified which factors influence the length of stay at home during the end of life. OBJECTIVE: The aim of this study was to identify factors influencing the amount of time spent at home during the final month of life among patients with advanced cancer. METHODS: A retrospective chart review was conducted for 415 patients with advanced cancer...
February 28, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28437205/-she-would-be-flailing-around-distressed-the-critical-role-of-home-based-palliative-care-for-patients-with-advanced-cancer
#19
Brook A Calton, Nicole Thompson, Nancy Shepard, Redwing Keyssar, Kanan Patel, Virginia Dzul-Church, Helen Kao, Christine Ritchie, Michael W Rabow
BACKGROUND: Patients with advanced cancer experience significant symptoms, ineffective treatments, and hospice underutilization. Home-based palliative care (HBPC) may fill a service gap for patients who require intensive home management, but are not enrolled in hospice. Even as data emerge on the utilization impacts of HBPC, other impacts are not as well known. METHODS: We describe findings of a pilot project in HBPC, Community Bridges (CB), for patients with advanced cancer...
February 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28437201/the-impact-of-community-based-palliative-care-on-utilization-and-cost-of-acute-care-hospital-services-in-the-last-year-of-life
#20
David Youens, Rachael Moorin
BACKGROUND: Community-based palliative care may potentially benefit patients by offering their preferred care at the end of life and benefit systems by reducing hospital use. OBJECTIVE: To compare place of death and acute care hospital use in the last year of life between cancer decedents who did and did not access a community-based palliative care service (PCS). DESIGN: Retrospective observational cohort study using linked individual administrative records from cancer registry, hospital, emergency department (ED), mortality, and PCS databases...
February 16, 2017: Journal of Palliative Medicine
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